HDFC ERGO Health Suraksha Regain Plan

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Highlights
  • Optimized health insurance plans at affordable cost
  • A network of more than 4800+ hospitals to choose from to avail cashless services
  • No limit for age at entry
  • Sum Insured 300000, 400000, 500000, 750000 & 1000000
  • AYUSH cover available without any sub limit
  • Enhanced Cumulative Bonus @ 10% per claim free year upto 100% of Sum insured
  • Option to choose from Individual or Family Floater Health Insurance plans
  • REGAIN benefit – Automatic availability of Sum Insured upon its exhaustion
  • Get benefits on Income Tax under Section 80D of the Income Tax Act
  • Enjoy hassle free claim procedures with least documentation and settlement times
  • No Sub-limits on any disease, room rent, hospital charges and doctor fees



Features
Schedule of Benefits - Individual & Family Floater
Basic Sum Insured per Policy Year Rs. 300000, Rs. 400000, Rs. 500000, Rs. 750000 & Rs. 1000000
In-patient Treatment Hospitalization costs due to illness or accident are covered upto the Policy Sum Insured
Pre-hospitalization Medical costs incurred during 60 days prior to hospitalization are reimbursed
Post-hospitalization Medical costs incurred during 90 day period following discharge post hospitalization are reimbursed
Day Care Procedures Expenses for 144 listed day care procedures that does not need 24 hours hospitalization on account of technological advancements are reimbursed
Domiciliary Treatment The Medical Expenses incurred by an Insured Person for medical treatment taken at his home which would otherwise have required Hospitalization on the advice of the attending Medical Practitioner, if the Insured Person could not be transferred to a Hospital or a Hospital bed was unavailable are reimbursed
Organ Donor Medical costs for harvesting an organ donated are reimbursed
Emergency Ambulance (Limit per hospitalisation) Upto Rs. 2,000 for SI 300000, 400000 & 500000 AND Rs 3,500 for SI 750000 & 1000000 reimbursed as ambulance expense during an emergency
AYUSH Benefit Inpatient treatment medical expenses under Homeopathy, Siddha, Ayurveda or Unani are reimbursed upto Sum Insured
Health Check Up Pays upto 1% of Sum Insured, maximum upto Rs. 5000 for a Health Checkup after 4 consecutive claim-free years
Regain Benefits Provides for an automatic availability of basic sum insured upon its exhaustion (inclusive of any cumulative bonus ) during the policy year
Enhanced Cumulative Bonus The basic sum insured of your policy cover will increase by 10% for every claim free year up to 100% of basic sum insured and will decrease by 10% in case of a claim
Regain Benefits

Policy provides for an automatic availability of basic sum insured upon its exhaustion (inclusive of any cumulative bonus) during the health insurance policy year

  • Basic sum insured will be re-instated only once in health insurance policy year
  • If the Regain SI is not utilized in a policy year, it shall not be carried forward to any subsequent insurance policy year.
  • Regain benefit cannot be withdrawn at subsequent renewals
  • Regain SI can be used for only future claims and not against any claim for an illness/disease (including its complications) for which a claim has been paid in the current policy year

Discounts
  • 10% discount for 2 Yr tenure of the policy.
  • Family Discount of 10% if 2 or more family members are covered under Health Suraksha on Individual Sum Insured basis.
Exclusions
  • Any treatment within first 30 days of cover except any accidental injury
  • Pre-existing conditions will not be covered for first 48 months
  • Expenses arising from HIV or AIDS and related diseases.
  • Mental disorder or insanity, cosmetic surgery, weight control treatment
  • Abuse of intoxicant or hallucinogenic substance like drugs and alcohol
  • Hospitalisation due to war / acts of war, nuclear, chemical / biological weapon & radiation of any kind
  • Pregnancy, dental and external aids and appliances unless covered under specific Plans
  • Terrorist activities, radioactivity or war

 
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